Usefulness of dipyridamole stress myocardial imaging in patients who have exercise limitations due to various orthopedic disorders

To evaluate the presence of coronary artery disease in patients unable to exercise adequately because of chronic rheumatoid arthritis, osteoarthritis, hip bone fractures or disk herniation, we performed dipyridamole-stress thallium-201 myocardial imaging in thirty-three patients. Twelve of the 33 patients showed perfusion defect and redistribution by thallium imaging. Coronary angiography was performed in 9 patients out of these 12 dipyridamole-positive patients and significant coronary artery stenosis was detected in 7 of them (78%). Due to these results of dipyridamole-imaging and coronary angiograms, surgical intervention for the underlying bone or joint disorder was performed under cardioprotective strategy in 15 patients, in which no cardiovascular events occurred. Thus, dipyridamole-stress myocardial imaging is a satisfactory alternative to the exercise test for detecting coronary artery disease in patients with bone or joint disorders. (author)